Materiały źródłowe

• #1 Management of Heatstroke and Heat Exhaustion | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0601/p2133.html

  Heat exhaustion and heatstroke are part of a continuum of heat-related illness. Both are common and preventable conditions affecting diverse patients. Treatment involves monitoring the patient in a cool, shady environment and ensuring adequate hydration. […] Prompt recognition and immediate cooling through evaporation or full-body ice-water immersion are crucial. […] Most experts believe that physicians and public health officials should focus greater attention on prevention. […] If a patient is suffering from heat-stroke, rapid diagnosis and effective cooling are crucial, because the condition triggers a series of metabolic events that may progress to irreversible injury or death. […] The initial treatment of patients with heat exhaustion involves stabilization in a cool area. […] An algorithm for the management of heat exhaustion and heatstroke is provided in Figure 1. Evaporative cooling may be initiated by wetting the skin. Electrolyte status and core temperature should be monitored.

• #2 Management of Heatstroke and Heat Exhaustion | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0601/p2133.html/1000

  Heat exhaustion and heatstroke are part of a continuum of heat-related illness. Both are common and preventable conditions affecting diverse patients. Treatment involves monitoring the patient in a cool, shady environment and ensuring adequate hydration. […] Prompt recognition and immediate cooling through evaporation or full-body ice-water immersion are crucial. […] Most experts believe that physicians and public health officials should focus greater attention on prevention. […] If a patient is suffering from heat-stroke, rapid diagnosis and effective cooling are crucial, because the condition triggers a series of metabolic events that may progress to irreversible injury or death. […] The initial treatment of patients with heat exhaustion involves stabilization in a cool area. […] An algorithm for the management of heat exhaustion and heatstroke is provided in Figure 1. Evaporative cooling may be initiated by wetting the skin. Electrolyte status and core temperature should be monitored.

• #3 Heat exhaustion and heatstroke

  https://www.nhs.uk/conditions/heat-exhaustion-heatstroke/

  Heat exhaustion does not usually need emergency medical help if you can cool down within 30 minutes. If it turns into heatstroke, it needs to be treated as an emergency. […] If someone is showing signs of heat exhaustion they need to be cooled down and given fluids. […] If someone has heat exhaustion, follow these 4 steps: Move them to a cool place. Remove all unnecessary clothing like a jacket or socks. Get them to drink a sports or rehydration drink, or cool water. Cool their skin spray or sponge them with cool water and fan them. Cold packs, wrapped in a cloth and put under the armpits or on the neck are good too. […] They should start to cool down and feel better within 30 minutes. […] You or someone else have signs of heatstroke, including: still unwell after 30 minutes of resting in a cool place, being cooled and drinking fluids, a very high temperature, hot skin that’s not sweating and might look red (this can be harder to see on brown and black skin), a fast heartbeat, fast breathing or shortness of breath, confusion and lack of coordination, a seizure or fit, loss of consciousness. […] Put the person in the recovery position if they lose consciousness while you’re waiting for help.

• #4 Heat Exhaustion: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21480-heat-exhaustion

  Heat exhaustion treatment involves cooling your body, hydrating and monitoring for signs of heat stroke. […] Treatment often begins on-site, wherever heat exhaustion happens this is because the faster you cool your body down, the better your chances of preventing a progression to heat stroke. […] If you have signs or symptoms of heat exhaustion, do these things right away: Call for medical help. Move to a cooler or shaded area. Loosen or remove excess clothes. Lie down with your legs elevated. Use any available means to cool your body like fanning yourself or soaking towels in ice water and applying them to your skin. Slowly sip water or other fluids. But do NOT drink anything if you suspect you might have heat stroke. Wait until help arrives. People with heat stroke are at risk of inhaling fluids (aspiration), which can be dangerous.

• #5 Heat Exhaustion: Symptoms, Causes, and Treatment | Red Cross

  https://www.redcross.org/take-a-class/resources/learn-first-aid/heat-exhaustion?srsltid=AfmBOooxPeTwYpdL9WFAvBKMYqNKw-Aq5kBabou6XtLmMuuCCiF9rWgP

  Heat exhaustion occurs when fluids lost through sweating are not replaced. […] Heat exhaustion is often accompanied by dehydration, as the body’s excessive production of sweat in an attempt to cool itself depletes fluid levels in the body. […] Call 9-1-1 and get equipment if the person requires immediate emergency medical treatment. […] General Care: Heat Exhaustion […] Move the person to a cooler environment with circulating air. […] If responsive and able to swallow, have them sip a cool electrolyte- and carbohydrate-containing fluid such as a sports drink, coconut water or milk. […] Give care for shock or dehydration, if necessary. […] If condition does not improve, or if person unable to take fluids or has a change in level of responsiveness or vomits, call 9-1-1 and then give care: […] Monitor for signs and symptoms of heat stroke, breathing problems or shock; give care as appropriate.

• #6 Heat exhaustion and heatstroke | nidirect

  https://www.nidirect.gov.uk/conditions/heat-exhaustion-and-heatstroke

  If you notice that someone has signs of heat exhaustion, you should: […] get them to lie down in a cool place, such as a room with air conditioning or somewhere in the shade […] remove any unnecessary clothing to expose as much of their skin as possible […] cool their skin use whatever you have available, such as a cool, wet sponge or flannel, cold packs around the neck and armpits, or wrap them in a cool, wet sheet […] fan their skin while it’s moist this will help the water to evaporate, which will help their skin cool down […] get them to drink fluids this should ideally be water, fruit juice or a rehydration drink, such as a sports drink […] do not give them aspirin or paracetamol (it will not help the raised temperature and may be harmful) […] Stay with the person until they’re feeling better. Most people should start to recover within 30 minutes.

• #7 Heat Exhaustion Signs and Treatment

  https://www.webmd.com/fitness-exercise/heat-exhaustion

  Treatment for Heat Exhaustion: If you have symptoms of heat exhaustion, it’s essential to immediately get out of the heat and rest, ideally in an air-conditioned room. If you can’t get inside, try to find the nearest cool and shady place. […] You should also: Drink water or sports drinks (avoid caffeine and alcohol) — taking small sips rather than big guzzles over about an hour […] Remove any tight or unnecessary clothing […] Take a cool shower, bath, or sponge bath […] Apply other cooling measures such as fans or ice towels. […] If you don’t feel better within an hour, seek medical help, because untreated heat exhaustion can progress to heat stroke. If your temperature rises or your symptoms get worse, don’t wait call 911 or go to an emergency room. […] If you are showing signs of heat stroke, you may be put in an ice bath or cooling blanket or, if those aren’t available, misted with cool water. You might also get medication to help you stop shivering.

• #8 What’s New

  https://www.cdph.ca.gov/Programs/EPO/pages/bi_natural-disasters_extreme-heat_tips-for-treating-heat-related-illness.aspx

  Heat exhaustion is less intense than heat stroke, but is still a serious health threat. It happens when the body has lost too much water and salt through sweat. Warning signs include heavy sweating, cramps, headache, nausea or vomiting, tiredness, weakness, dizziness and fainting. If heat exhaustion is not treated, it can turn into heat stroke. Help the victim cool off with: […] Cool, nonalcoholic beverages. […] Rest, lying down. […] Cool shower, bath or sponge bath. […] Air-conditioning. […] Get medical help if the symptoms are severe or if the victim has heart problems or high blood pressure. […] Heat cramps are muscle pains and spasms triggered by heavy activity. They usually involve the stomach muscles or the legs. It is generally thought that the loss of water and salt from heavy sweating causes the cramps. When this occurs: […] Stop all activities and find a cool place to sit quietly. […] Drink water or a sports beverage. […] Rest for a few hours to avoid heat exhaustion or heat stroke. […] Get medical help if heat cramps do not stop after one hour. […] If the individual suffering from heat cramps has a heart condition or is on a low-sodium diet, seek medical attention immediately.

• #9 Heat Exhaustion – Injuries; Poisoning – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/injuries-poisoning/heat-illness/heat-exhaustion

  Heat exhaustion is a nonlife-threatening clinical syndrome of weakness, malaise, nausea, syncope, and other nonspecific symptoms caused by heat exposure. Treatment involves rest in a cool environment and replacing fluids and electrolytes. […] Treatment of heat exhaustion involves stopping all exertion and removing patients to a cool environment, having them lie flat, and attempting oral rehydration with a solution of 0.1% sodium chloride. Patients should drink about 1 L/hour. If vomiting or nausea prevents oral rehydration, IV fluid and electrolyte replacement therapy, typically using 0.9% saline solution, is indicated. Also, if symptoms do not resolve after 30 to 60 minutes of oral rehydration, patients should be transported to an emergency department, where rehydration is usually done IV. Rate and volume of IV rehydration are guided by age, underlying disorders, and clinical response. Replacement of 1 to 2 L at 500 mL/hour is often adequate. Older patients and patients with heart disorders may require lower rates. […] Have patients rest in a cool environment and try oral rehydration, transporting patients to an emergency department if these measures are unsuccessful.

• #10 Heatstroke and heat exhaustion | Australian Red Cross

  https://www.redcross.org.au/emergencies/prepare/heatstroke-and-heat-exhaustion/

  Heat exhaustion happens when someone becomes dehydrated due to fluid loss from a hot environment and/or excessive physical activity. […] Treatment: Help the person to lie down in a cool or shady area to monitor. Remove excessive clothing and loosen any tight clothing. Immerse hands and feet in cold water, cool by fanning and moisten the skin, if possible. If fully alert and responsive, give them frequent small drinks of water. If muscle cramps occur, gently stretch the affected muscles to ease pain. […] Heatstroke is a life-threatening emergency and can cause a person to collapse or fall unconscious. […] Treatment: Immediately call 000 for an ambulance. If available, have the person take a cold shower or bath. Cool the person with household items such as wet towels, fans or icepacks placed in the neck, groin and armpits. If unresponsive or not alert, place in the recovery position. Prepare to give CPR if necessary.

• #11 Management of Heatstroke and Heat Exhaustion | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0601/p2133.html

  Patients who are significantly dehydrated, who are hyponatremic, or who have mental status changes or central nervous system irritability should be transferred to an appropriate medical facility. […] Prompt reversal of hyperthermia is the cornerstone of heatstroke treatment. […] Immediate initiation of rapid and effective cooling is crucial in a patient with heatstroke. […] Cooling methods generally are categorized as external or internal. […] External methods include evaporative and immersion cooling, with evaporative methods being most commonly used in the field. […] Internal cooling methods are more effective in rapidly decreasing temperature. […] Medications have shown little efficacy in treating heatstroke. […] Cooling usually is discontinued once the core temperature has reached 38C (100.4F), though close monitoring should continue. […] Heatstroke must be viewed as multisystem failure.

• #12 Management of Heatstroke and Heat Exhaustion | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0601/p2133.html/1000

  Patients who are significantly dehydrated, who are hyponatremic, or who have mental status changes or central nervous system irritability should be transferred to an appropriate medical facility. […] Prompt reversal of hyperthermia is the cornerstone of heatstroke treatment. […] Immediate initiation of rapid and effective cooling is crucial in a patient with heatstroke. […] Cooling methods generally are categorized as external or internal. […] External methods include evaporative and immersion cooling, with evaporative methods being most commonly used in the field. […] Internal cooling methods are more effective in rapidly decreasing temperature. […] Medications have shown little efficacy in treating heatstroke. […] Cooling usually is discontinued once the core temperature has reached 38C (100.4F), though close monitoring should continue.

• #13 Heat Exhaustion Signs and Treatment

  https://www.webmd.com/fitness-exercise/heat-exhaustion

  Heat exhaustion usually goes away with rest and fluids. You should feel better within an hour. […] When heat exhaustion symptoms don’t get better with an hour of rest and fluids, seek medical care. Get help immediately if someone with signs of heat exhaustion: Can’t drink or keep fluids down […] Has a body temperature of 104 F or more […] Has trouble speaking, standing, or walking […] Keeps sweating heavily […] Seems confused […] Passes out.

• #14 Heat exhaustion Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/condition/heat-exhaustion

  If you have symptoms of heat exhaustion, you should see a doctor immediately. The doctor will perform a physical examination, check your blood pressure, pulse, and temperature, and assess how dehydrated you are. The doctor may also request lab tests of blood and urine samples. […] The primary treatment for heat exhaustion is to rest in a shady spot or, better, an air-conditioned room, and to drink cool (not icy) fluids. You can lower core body temperature by immersing yourself in cold water or spraying yourself with cold water and fanning. Water is usually enough to reverse dehydration, but you can also drink a sports drink that contains electrolytes. […] Your health care provider may recommend an oral or intravenous saline electrolyte solution. […] Providers may recommend drinking fluids that contain electrolytes (see Prevention section). Endurance athletes may want to take mineral supplements, including: Calcium, Magnesium, Potassium.

• #15 Heat Stroke Treatment & Management: Medical Care

  https://emedicine.medscape.com/article/166320-treatment

  Heat stroke is a medical emergency and continues to be one of the leading causes of preventable death in sports. Rapid reduction of the core body temperature is the cornerstone of treatment because the duration of hyperthermia is the primary determinant of outcome. Patients diagnosed with exertional heat stroke (EHS) or nonexertional heat stroke (NEHS) should be admitted to the hospital for at least 48 hours to monitor for complications. […] Once heat stroke is suspected, cooling must begin immediately and must be continued during the patient’s resuscitation. The American College of Sports Medicine recommends that cooling be initiated at the scene, before transporting the patient to an emergency department for further evaluation and treatment. […] Rehydration therapy alone is insufficient for heat stroke patients and should be combined with active cooling.

• #16 Heat Stroke Treatment & Management: Medical Care

  https://emedicine.medscape.com/article/166320-treatment

  Some studies have shown that promptly reducing the exposure time to excessive heat can dramatically improve long-term outcomes and decrease irreversible injury. If treatment is initiated within this so-called golden hour and is aggressive enough to rapidly reduce the core body temperature, complications (including multisystem organ failure) may be averted and the patient may have a much better prognosis. […] Removal of restrictive clothing and spraying water on the body, covering the patient with ice watersoaked sheets, or placing ice packs in the axillae and groin may reduce the patient’s temperature significantly. Patients who are unable to protect their airway should be intubated. Patients who are awake and responsive should receive supplemental oxygen. […] Intravenous lines may be placed in anticipation of fluid resuscitation and for the infusion of dextrose and thiamine if indicated. Hypoglycemia is a common occurrence in patients with EHS and may be a manifestation of liver failure; therefore, infusion of dextrose 50% in water solution (D50W) should be considered in all patients with heat stroke.

• #17 Heat exhaustion – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/heat-exhaustion/diagnosis-treatment/drc-20373253

  If you don’t begin to feel better within one hour of using these treatment measures, seek prompt medical attention. […] To cool your body to a normal temperature, your health care team may use these heatstroke treatment techniques: […] Immerse you in cold water. A bath of cold or ice water has proven to be the most effective way of quickly lowering the core body temperature. The quicker you can receive cold water immersion, the less risk of organ damage and death. […] Use evaporation cooling techniques. If cold water immersion is not an option, health care professionals may try to lower your body temperature using an evaporation method. Cool water is misted on your body while warm air is fanned over you. This causes the water to evaporate and cool your skin. […] Pack you with ice and cooling blankets. Another method to lower your temperature is to wrap you in a special cooling blanket and apply ice packs to your groin, neck, back and armpits. […] Give you medications to stop your shivering. If treatments to lower your body temperature make you shiver, your doctor may give you a muscle relaxant, such as a benzodiazepine. Shivering increases your body temperature, making treatment less effective.

• #18 Heatstroke – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/heat-stroke/diagnosis-treatment/drc-20353587

  Heatstroke treatment centers on cooling the body to a standard temperature to prevent or reduce damage to the brain and vital organs. To do this, a healthcare professional may take these steps: […] Immersion in cold water. A bath of cold or ice water has been proved to be the most effective way of quickly lowering the core body temperature. The quicker someone with heatstroke receives cold water immersion, the less risk of death and organ damage. […] Use evaporation cooling techniques. If cold water immersion is not available, healthcare professionals may try to lower body temperature using an evaporation method. Cool water is misted on the body while warm air is fanned over the person, causing the water to evaporate and cool the skin. […] Packing with ice and cooling blankets. Another method is to wrap a person in a special cooling blanket and apply ice packs to the groin, neck, back and armpits to lower temperature. […] Give medicines to stop shivering. If treatments to lower body temperature make you shiver, your doctor may give you a muscle relaxant, such as a benzodiazepine. Shivering increases your body temperature, making treatment less effective.

• #19 Guideline for the Treatment of Heat Stroke | SCCM

  https://www.sccm.org/clinical-resources/guidelines/guidelines/guideline-for-the-treatment-of-heat-stroke

  Predicted increases in heat-related weather phenomena will result in increasing heat exposures and heat injuries such as heat stroke. Prompt recognition, early intervention, and evidence-based management are necessary to optimize outcomes. These SCCM guidelines outline recommendations for the treatment of patients with heat stroke. […] Active cooling measures are recommended over passive cooling methods, with cold- or ice-water immersion achieving the fastest cooling rate. This method should be prioritized where available. In patients with heat stroke, there is no evidence to support pharmacological interventions that affect temperature control, so they should be avoided. […] We recommend active cooling methods over passive cooling in patients with heat stroke. Quality of evidence: Very low.

• #20 Guideline for the Treatment of Heat Stroke | SCCM

  https://www.sccm.org/clinical-resources/guidelines/guidelines/guideline-for-the-treatment-of-heat-stroke

  Clinicians should prioritize cooling methods that achieve the most rapid rate of cooling. This includes ice-water immersion (1-5 C) or cold-water immersion (9-12 C). […] Clinicians should choose cooling methods that reach the target temperature within 30 minutes from recognition of heat stroke symptoms. […] Clinicians should prioritize cooling modalities that achieve a cooling rate greater than or equal to 0.155 C/min. […] We recommend against the use of dantrolene in patients with heat stroke. Quality of evidence: Very low. […] The routine use of acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDS), and salicylates for temperature reduction should be avoided. […] Prophylactic antibiotics or prophylactic antiseizure medications should only be used in the context of research.

• #21 Hyperthermia & heat stroke – EMCrit Project

  https://emcrit.org/ibcc/hyperthermia/

  Some patients with hyperthermia have a causative problem that requires specific management (e.g. brainstem stroke, meningitis, septic shock). However, the most important aspect of care overall is usually meticulous and aggressive supportive care. […] May be important, regardless of whether the patient is intubated. […] Shivering will impair temperature management and should be controlled during the acute cooling phase. […] For the intubated patient, paralysis with a non-depolarizing muscle relaxant may be used to control shivering. […] The techniques below are intended to be initiated immediately and used simultaneously. […] The most important technique is surface cooling which is absolutely essential. Agressive surface cooling will work fine on its own. However, internal and respiratory cooling are useful adjunctive techniques which are easy and may help achieve target temperature faster.

• #22 Hyperthermia & heat stroke – EMCrit Project

  https://emcrit.org/ibcc/hyperthermia/

  An immersive ice bath is the most effective method of physical cooling (achieving rates of ~0.2 C per minute). […] If an immersive ice bath isn’t available: evaporative cooling. […] Evaporation is very effective at cooling the body (roughly ~0.1 C per minute, roughly half as fast as immersive cooling). […] These complications should be treated using standard supportive measures. Consider monitoring laboratory studies (especially creatinine kinase and liver function tests) over the first 24 hours to watch for the emergence of these problems. […] There’s no role for acetaminophen or other antipyretic medications (hyperthermia isn’t mediated by the thalamus, so these medications will have no efficacy).

• #23 Heat Stroke Treatment & Management: Medical Care

  https://emedicine.medscape.com/article/166320-treatment

  The goal of treatment is to reduce the temperature by at least 0.2C/min to approximately 39C. […] Antipyretics (eg, acetaminophen, aspirin, other nonsteroidal anti-inflammatory drugs) have no role in the treatment of heat stroke because antipyretics interrupt the change in the hypothalamic set point caused by pyrogens; they are not expected to work on a healthy hypothalamus that has been overloaded, as in the case of heat stroke. […] Immediate administration of benzodiazepines is indicated in patients with agitation and shivering, to stop excessive production of heat. […] Recommendations on the administration of intravenous fluids for circulatory support differ among patient populations and depend on the presence of hypovolemia, preexisting medical conditions, and preexisting cardiovascular disease.

• #24 Heatstroke – Injuries; Poisoning – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/injuries-poisoning/heat-illness/heatstroke

  Heatstroke is hyperthermia accompanied by a systemic inflammatory response causing multiple organ dysfunction that may result in death. […] Treatment includes rapid external cooling, IV fluid resuscitation, and support as needed for organ dysfunction. […] The importance of rapid recognition and effective, aggressive cooling cannot be overemphasized. […] The main cooling techniques are cold water immersion and evaporative cooling. […] Cold water immersion results in the lowest morbidity and mortality rates and is the treatment of choice when available. […] Evaporative cooling is also very effective and works best if the patient has adequate peripheral circulation. […] Cooling measures should be stopped once temperature reaches approximately 39 C to avoid overcooling and causing iatrogenic hypothermia.

• #25 Heat Stroke – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537135/

  Adequate rehydration is essential without over-correcting the sodium if derangements exist. It is mandatory to continually measure core temperature with a rectal or esophageal probe, and cooling measures should be stopped once the temperature is 38 to 39 degrees Celsius. […] Several pharmacologic adjuncts also merit consideration in the treatment of heat stroke. Dantrolene is a skeletal muscle relaxer, shown to reduce heat production in sustained muscle contracture, and is useful for treating malignant hyperthermia. However, it has been shown that heat stroke does not affect patient outcomes. […] The use of benzodiazepines in heat stroke may have merit for a patient who is agitated and shivering; however, empiric treatment is inadvisable until further studies are undertaken. […] Finally, expedited rapid cooling has been shown in several RCT both directly and indirectly to be the most effective treatment to limit mortality in heatstroke.

• #26 Heat stroke in children – UpToDate

  https://www.uptodate.com/contents/heat-stroke-in-children

  We suggest that children with heat stroke undergo prehospital treatment with either cold-water immersion (if equipment and trained personnel are immediately available for initiation of this technique), tarp-assisted cooling or evaporative external cooling while ensuring expeditious transport to definitive care. […] For hospital treatment of children with heat stroke, we suggest evaporative cooling rather than rapid cooling with cold-water immersion. […] Children with heat stroke require aggressive treatment because the extent of end-organ damage and mortality is related to the duration of hyperthermia. […] We suggest that patients with heat stroke receive IV benzodiazepines (eg, midazolam or lorazepam) to prevent or to treat shivering during cooling measures, especially if a cooling blanket or ice packs are being used.

• #27 Heat stroke in children – UpToDate

  https://www.uptodate.com/contents/heat-stroke-in-children

  After stabilization and rapid cooling, the child with heat stroke remains at high risk for multiple organ failure, metabolic abnormalities, and disorders of coagulation. […] Antipyretic medications (eg, acetaminophen, ibuprofen) are ineffective for the treatment of hyperthermia in heat stroke victims and should not be used because they may exacerbate liver injury (acetaminophen) or cause kidney injury or gastrointestinal bleeding (ibuprofen). […] All children with heat stroke should be admitted to a pediatric critical care unit setting in order to maintain appropriate monitoring and to treat ongoing and delayed end-organ dysfunction. […] The prognosis in children with heat stroke is poorly characterized. Extrapolation from studies in adults suggests that morbidity or mortality are directly related to duration and degree of hyperthermia.

• #28 Heat Stroke Treatment & Management: Medical Care

  https://emedicine.medscape.com/article/166320-treatment

  Treatment of rhabdomyolysis involves infusion of large amounts of intravenous fluids (fluid requirements may be as high as 10 L), alkalinization of the urine, and infusion of mannitol. […] Treatment of hepatic failure includes the following: Infusion of dextrose solutions to correct hypoglycemia, Early recognition and treatment of DIC, with replacement of clotting factors, fresh frozen plasma, platelets, and blood, Meticulous respiratory support. […] Acute kidney injury (AKI) may occur because of direct thermal injury of the kidney, myoglobinuria, hypotension, and/or shock (acute tubular necrosis). AKI initially is treated with intravenous fluids, diuretics, and correction of associated acid-base and electrolyte abnormalities.

• #29 Heat Stroke: Symptoms, Treatment & Recovery

  https://my.clevelandclinic.org/health/diseases/21812-heatstroke

  Heat stroke treatment involves quickly cooling down your body and monitoring for complications. This requires care in an emergency room. […] Call 911 immediately if you (or someone you’re with) has signs of heat stroke. But don’t wait for help to arrive to begin treating heat stroke. The sooner your body starts cooling down ideally within 30 minutes of the start of symptoms the better your chances of recovery. […] Heat stroke first aid involves moving the person out of the sun or heat to a cooler spot, pouring water over their skin and using anything available to fan them, soaking a towel in ice water and applying it to their skin, and applying ice or cold packs to their armpits or neck. […] Healthcare providers in the emergency room focus on cooling your body until it gets to a safe temperature. Common methods for cooling include cold water immersion and misting and fanning. […] Providers will closely monitor you for signs of complications and give you further treatment as needed. This might include IV fluids, intubation, and medications to support organ function.

• #30 Expert consensus on standardized diagnosis and treatment for heat stroke | Military Medical Research | Full Text

  https://mmrjournal.biomedcentral.com/articles/10.1186/s40779-015-0056-z

  Rapid cooling is the most important treatment measure. The case fatality rate is closely related to hyperthermia and its duration. If cooling is delayed, the fatality rate increases significantly. […] Cooling targets are to quickly cool the core temperature to 39 C or below within 10-40 min and to 38.5 C or below within 2 h. […] A patient who has one of the following conditions may be considered for continuous bedside continuous renal replacement therapy (CRRT). […] Indications for CRRT Termination: stability in vital signs and the patients condition; CK1,000 U/L; correction in the water, electrolyte, and acid-base imbalance; urine output1500 ml/day or resumption of normal renal function. […] Infection can be resisted in the early stage by the prophylactic use of antibiotics such as second generation cephalosporin antibiotics. If there is infection, collect relevant specimens for smears and culture in a timely manner, increase the level of antibiotics, and add anti-fungals as necessary.

• #31 Heatstroke: Symptoms, Causes, First Aid, Recovery, and More

  https://www.healthline.com/health/heat-stroke

  Heatstroke is a medical emergency that always requires immediate assistance and treatment. […] If you or someone else is experiencing heatstroke symptoms, do what you can to bring down body temperature while waiting for emergency medical aid. […] Once you receive a diagnosis, medical treatment that’s designed to bring down your core body temperature will be given. […] A healthcare professional may use various techniques to lower your temperature such as: cold-water immersion, evaporative cooling, cooling blankets, ice packs, cooled-down intravenous (IV) fluids, cold-water lavage. […] Cooling the body down is essential for lowering the risk of complications from heatstroke such as heart, brain, or kidney damage. […] If needed, you may receive IV fluids to treat dehydration. […] During the cooling process, your temperature will be consistently monitored for hypothermia.

• #32 Heatstroke: Symptoms, Causes, First Aid, Recovery, and More

  https://www.healthline.com/health/heat-stroke

  Medications, such as muscle relaxers, may be given to stop shivering. […] Thermal instability, or trouble regulating body temperature, is common after heatstroke. […] You can expect your body temperature to fluctuate more than usual for several weeks. […] A healthcare professional will recommend monitoring tests that assess kidney and liver function during and after recovery. […] Heatstroke is a life threatening emergency that requires immediate medical treatment.

• #33 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Diagnosis-and-treatment-of-heat-stroke.aspx

  In the hospital fluids and electrolytes are administered as necessary while closely monitoring breathing, airway and maintenance of blood circulation. […] Ice packs are applied to the patient’s neck, armpits and groins to cool at around 0.1C/minute. Ice-bath immersion has been shown to be the most effective cooling method. […] Cooling is slowed or stopped once the temperature is 38.5C, to avoid overcooling. Iced gastric lavage and peritoneal lavage is attempted in severe cases. […] Medications like Benzodiazepines and muscle relaxants are given to control shivering and fits. […] Complications like respiratory distress, encephalopatrhy (brain disorder), rhabdomyolysis, kidney or liver damage is managed according to severity and symptoms.

• #34 Heat stroke in adults – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/3000174

  Patients are at risk of multi-system organ failure, so careful monitoring is essential even after return to normothermia. […] This topic covers the management of both heat stroke and heat exhaustion in adults. […] If untreated, heat exhaustion can progress to heat stroke. Heat stroke, however, can occur without preceding heat exhaustion.

• #35 Heat Stroke: Symptoms, Causes and Treatment | Red Cross

  https://www.redcross.org/take-a-class/resources/learn-first-aid/heat-stroke?srsltid=AfmBOor0tHX0bYws-_FWkGzjH-m_KCC34MV49RDRFnw_ELGKqKW-PkBO

  General Care: Heat Stroke […] 1. After calling 9-1-1, apply one of the following rapid cooling methods based on your resources: […] 1. Immediately immerse them up to their neck in cold water if safe to do. […] 2. Apply cold, wet cloths or towels to skin; then apply ice packs and fan them. […] 3. Have the person take a cold shower. […] […] 2. Continue methods for 20 minutes, until the person feels better or EMS arrives. […] 3. Continue checking them as appropriate to determine if additional care is needed. […] 4. Give care for shock, if necessary. […] 5. Reassure person you will help and EMS has been called (if appropriate). […] 6. Watch for changes in condition, including breathing and responsiveness, and give care as appropriate and trained.

• #36 Heat Cramps, Exhaustion, Stroke

  https://www.weather.gov/safety/heat-illness

  Heat exhaustion […] First Aid: Move person to a cooler environment, preferably a well air-conditioned room. Loosen clothing. Apply cool, wet cloths or have person sit in a cool bath. Offer sips of water. Seek immediate medical attention if the person vomits, symptoms worsen or last longer than 1 hour […] Heat Stroke […] First Aid: Call 911 or get the victim to a hospital immediately. Heat stroke is a severe medical emergency. Delay can be fatal. Move the victim to a cooler, preferably air-conditioned, environment. Reduce body temperature with cool cloths or bath. Use fan if heat index temperatures are below the high 90s. A fan can make you hotter at higher temperatures. Do NOT give fluids.

• #37 Heat exhaustion or heat stroke? Know the signs of heat illness | National Oceanic and Atmospheric Administration

  https://www.noaa.gov/stories/heat-exhaustion-or-heat-stroke-know-signs-of-heat-illness

  No matter what your job is or how you spend your free time, prevention of heat-related illness is key. […] Seek immediate medical attention if you experience symptoms of heat illness. (See chart below for symptoms, likely conditions and treatment.) […] Heavy sweating, weakness, cool skin, pale and clammy. Weak pulse. Normal temperature possible. Possible muscle cramps, dizziness, fainting, nausea and vomiting. […] Move individual out of sun, lay them down, and loosen clothing. […] Apply cool, wet cloths. […] Fan or move individual to air conditioned room. […] Give sips of water; if nausea occurs, discontinue water intake. […] If vomiting continues, seek immediate medical attention. […] Altered mental state. Possible throbbing headache, confusion, nausea and dizziness. High body temperature (106F or higher). Rapid and strong pulse. Possible unconsciousness. Skin may be hot and dry, or patient may be sweating. Sweating likely especially if patient was previously involved in vigorous activity.

• #38 Heat exhaustion or heat stroke? Know the signs of heat illness | National Oceanic and Atmospheric Administration

  https://www.noaa.gov/stories/heat-exhaustion-or-heat-stroke-know-signs-of-heat-illness

  Heat stroke is a severe medical emergency. […] Summon emergency medical assistance or get the individual to a hospital immediately. […] Delay can be fatal. […] Move individual to a cooler, preferably air-conditioned, environment. […] Reduce body temperature with a water mister and fan or sponging. […] Use air conditioners. Use fans if heat index temperatures are below the high 90s. Use extreme caution. […] Remove clothing. If temperature rises again, repeat process. Do not give fluids.

• #39 Heat-related illness signs, symptoms and treatment | SA Health

  https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/healthy+living/protecting+your+health/environmental+health/healthy+in+the+heat/heat-related+illness+signs+symptoms+and+treatment

  If the person is unconscious: move the person to somewhere cool and keep them still if possible; lay them on their side (recovery position) and check they can breathe properly; perform CPR if needed; do not give aspirin or paracetamol to a person affected by heat; stay with them until the ambulance arrives.

• #40 Heat Exhaustion: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21480-heat-exhaustion

  When emergency services personnel arrive, theyll immediately look for any signs of heat stroke. They may do things to cool you down, like fanning you after misting your skin with cool water. They may take you to a hospital so you can receive IV fluids or faster methods of cooling. […] If your heat exhaustion progresses to heat stroke, youll need to stay a couple nights or longer at the hospital. Providers will give you further treatment and monitor your condition.

• #41 Heat Stroke – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537135/

  Heatstroke is a severe heat-related illness involving an elevation in body temperature, typically but not always greater than 40 C. The patient has clinical signs of central nervous system dysfunction that may include confusion, ataxia, delirium, or seizures brought on after strenuous physical exertion or exposure to hot weather. This activity illustrates the evaluation and treatment of heat stroke and reviews the role of the interprofessional team in this condition. […] Management of heat stroke includes ensuring adequate airway protection, breathing, and circulation. After ABCs, rapid cooling becomes the mainstay of treatment with ancillary management in response to other end-organ damage. Intubation for profound unconsciousness is rarely needed, as rapid cooling quickly improves the Glasgow coma scale.

• #42 Heatstroke – Injuries; Poisoning – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/injuries-poisoning/heat-illness/heatstroke

  Necessary resuscitation should proceed while cooling is done. […] IV hydration with 0.9% saline solution should be started with 1 to 2 L of cooled 0.9% saline to help decrease core temperature. […] Patients should be admitted to an intensive care unit and observed for multiple organ dysfunction, disseminated intravascular coagulation, and rhabdomyolysis. […] Antipyretics have no value and can contribute to liver or kidney damage. […] Rapid recognition of heatstroke and effective, aggressive cooling are extremely important. […] Use cool water immersion or evaporative cooling to rapidly cool the patient. […] Patients will require intensive care monitoring with aggressive supportive care.

• #43 How is Heat Stroke Treated in the Emergency Room?

  https://mhehc.com/blog/how-is-heat-stroke-treated-in-the-emergency-room/

  Heat stroke is a severe heat-related illness that requires immediate medical attention. […] Heat stroke is a medical condition that requires immediate treatment. […] The following treatment options may be employed: Rapid Cooling: The primary goal of treating heat stroke is quickly lowering body temperature. […] Intravenous Fluids: Dehydration is a standard complication of heat stroke. […] Oxygen and Ventilation Support: In severe cases of heat stroke, patients may experience difficulty breathing or respiratory distress. […] Monitoring and Support: Continuous monitoring of vital signs, including heart rate, oxygen saturation, and body temperature, is crucial in the ER. […] Treatment of Complications: Heat stroke can cause organ damage and other complications. […] The ER staff is trained to provide rapid cooling, intravenous fluids, monitoring, and other necessary interventions to treat heat stroke effectively.

• #44 Heat Stroke: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/166320-overview

  Heat stroke is defined as hyperthermia exceeding 40C (104F) associated with an altered sensorium. […] The optimal method of rapidly cooling patients has been a matter of debate for some time. A 2013 guideline from the Wilderness Medical Society recommends ice-water immersion as a superior method for rapidly lowering core body temperature below the critical levels normally found in heat stroke patients. […] Ice-water immersion or an equivalent method has the advantage of rapidly reducing core body temperature. […] Evaporative heat loss, although perhaps less effective than immersion techniques, poses fewer practical difficulties. […] A number of other cooling techniques have been suggested, but none has proven superior to or equal to cold-water immersion or evaporative techniques. […] Cardiopulmonary bypass has been suggested for use in the most severe cases.

• #45 Heat Stroke (Hyperthermia) – Harvard Health

  https://www.health.harvard.edu/a_to_z/heat-stroke-hyperthermia-a-to-z

  The first step in treating heat stroke is to reduce body temperature by cooling the body from the outside. This can be done by removing tight or unnecessary clothing, spraying the person with water, blowing cool air on the person, or wrapping the person loosely in wet sheets. Alternatively, ice packs can be placed at the neck, groin and armpits to accelerate cooling. […] Severe cases may require cardiopulmonary bypass, in which the person’s blood is diverted from the heart and lungs into a collection machine, cooled, and then returned to the body. […] In some cases, anti-seizure or muscle-relaxing medications may be given to control convulsions and shivering. Aspirin and acetaminophen (Tylenol) do not help lower body temperature when a person has heat stroke, and these medications should be avoided if heat stroke is suspected.

• #46 How to Handle Heat Illness (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/heat-exhaustion-heatstroke-sheet.html

  In very hot weather, high humidity, and other conditions, body heat can build to dangerous levels. This can cause heat illness, such as heat cramps, heat exhaustion, or heatstroke. Heat exhaustion starts slowly, but if it’s not quickly treated it can progress to heatstroke. In heatstroke, a person’s temperature reaches 105F (40.5C) or higher. Heatstroke needs emergency medical care right away and can be life-threatening. […] If your child has symptoms of heatstroke, get emergency medical care right away. […] For cases of heat exhaustion or while awaiting help for a child with possible heatstroke: Bring the child indoors or into the shade right away. Undress the child. Have the child lie down; raise their feet slightly. If the child is alert, place in a lukewarm bath, spray with lukewarm water, or put cool cloths on their skin. If the child is alert and coherent, give frequent sips of cool, clear fluids. If the child is vomiting, turn onto their side to prevent choking.

• #47 Heat Exhaustion and Heat Stroke – Symptoms | familydoctor.org

  https://familydoctor.org/condition/heat-exhaustion-heatstroke/

  Heat exhaustion and heatstroke treatment If you or someone else has heat exhaustion, treat symptoms in the following ways. Get out of the heat quickly and into a cool place, or at least shade. Lie down and elevate your legs to get blood flowing to your heart. Take off any tight or extra clothing. Apply cool towels to your skin or take a cool bath. This will help regulate and lower your internal body temperature. Drink fluids, such as water or a sports drink. Do not guzzle them, but take sips. Do not drink fluids with caffeine or alcohol. […] Call 911 if: Symptoms don’t improve or they still have a fever of 102°F after 30 minutes of initial treatment. The person goes into shock, faints, or has seizures. The person is not breathing. You also should begin CPR right away to try and revive them. […] After you’ve had heat exhaustion or heatstroke, you will be sensitive to heat. This can last for about a week. It’s important to rest and let your body recover. Avoid hot weather and exercise. Ask your doctor when it’s safe to return to your normal activities.

• #48 How To Recover From Heat Exhaustion | Franciscan Health

  https://www.franciscanhealth.org/community/blog/recovering-heat-illness-athletes

  Many athletes and exercise enthusiasts forget how critical it is to be aware of how extreme heat during exercise can affect your body. […] Prolonged exposure to high temperatures, particularly when it is humid outside, increases your risk of heat-related illnesses such as heat exhaustion and heat stroke. […] The following tips should be used for athletes recovering from a heat exhaustion, heat stroke or illness and/or heat injury. […] To restore proper level of hydration, 20 oz. of fluid should be consumed for every pound (16 oz.) of fluid lost during activity. Appropriate fluids include water and sports drinks designed to restore electrolyte balance within the body. […] Rest in air conditioning or another cool environment. Place cool wet towels on forehead and neck. Stay out of the sun.

• #49 How To Recover From Heat Exhaustion | Franciscan Health

  https://www.franciscanhealth.org/community/blog/recovering-heat-illness-athletes

  Eat well-balanced meals to replenish nutrients within the body. Meals should ideally include more carbohydrate sources than fat and protein. […] Recovery from heat illness depends on how severe the heat illness was. […] It is recommended that athletes with exercise-associated muscle (heat) cramps, heat syncope or heat exhaustion wait to return to play until after 24 hours of rest. […] Athletes with exertional heat stroke may initiate return after the patient has completed the following: 7 to 21-day rest period, Demonstrated normal blood-work results, Obtained physician clearance. […] The athlete may begin a progression of physical activity, supervised by the athletic trainer or other medical professional with knowledge of exertional heat stroke treatment and care, from low intensity to high intensity and increasing duration in a temperate environment.

• #50 Heat Stroke Treatments? – NowPatient

  https://nowpatient.com/blog/heat-stroke-treatments

  Heatstroke is a preventable condition, and taking proactive measures can significantly reduce the risk of this life-threatening emergency. By implementing a comprehensive approach to heat-related illness prevention, individuals can safeguard their health and well-being during periods of extreme heat. […] Recovering from a heatstroke episode can be a complex and arduous process, with the potential for long-lasting complications and an increased risk of future heat-related illnesses. […] Heatstroke is a medical emergency that demands immediate intervention to prevent devastating consequences. By understanding the underlying causes, recognizing the early warning signs, and mastering the latest treatment strategies, individuals can be better equipped to confront this life-threatening condition with confidence and resilience.

• #51 Heat Stroke vs. Heat Exhaustion: What’s the Difference?

  https://www.healthline.com/health/heat-stroke-vs-heat-exhaustion

  If the cold causes you to shiver, your doctor may give you medications to stop the shivering. This might increase your body temperature. […] With treatment, you can fully recover from heat exhaustion. Early intervention can also stop it from progressing to heat stroke. […] Experiencing a heat stroke is an emergency. If left untreated, it can cause damage to your: heart, kidneys, muscles, liver, lungs, brain. […] Your risk for serious complications, including death, increases the longer treatment is delayed.

• #52 Heat Stroke vs. Heat Exhaustion: What You Need to Know | University Hospitals

  https://www.uhhospitals.org/blog/articles/2019/07/heat-stroke-vs-heat-exhaustion-what-you-need-to-know

  Heat stroke develops rapidly and needs immediate medical treatment. […] If you suspect heat stroke, that’s a 9-1-1 call, Dr. McNeeley says. […] If you think you have heat exhaustion, Dr. McNeeley says it’s essential to immediately get out of the sun or heat and rest in air-conditioning or in front of a fan. Drink plenty of fluids, remove excess clothing and, if possible, take a cool shower, bath or sponge bath. […] If you don’t feel better within about 15 minutes, it’s important to get medical attention at an urgent care, Dr. McNeeley says. Heat exhaustion can progress to heat stroke, which is life-threatening. […] Heat exhaustion is not something you recover from right away, Dr. McNeeley says. It may take up to three or four days until your body is back to normal. During that time you’ll need to rest and stay out of the heat and humidity. […] You may need days to get better, Dr. McNeeley says.

• #53 Heat Stroke: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/166320-overview

  During the initial phase of therapy, neuromuscular blockade with muscular paralysis should be considered for patients who are not cooling adequately. […] Long-term outpatient therapy may be required when chronic renal failure develops and when irreversible damage to the CNS, lungs, heart, and liver occurs. […] Education is the single most important tool for the prevention of heat stroke. […] Recognition of host risk factors and modification of behavior (eg, limiting alcohol and drug intake, avoiding use of medications and drugs that interfere with heat dissipation) and physical activity also can prevent heat stroke.

• #54 Management of heatstroke and heat exhaustion – PubMed

  https://pubmed.ncbi.nlm.nih.gov/15952443/

  Heat exhaustion and heatstroke are part of a continuum of heat-related illness. […] Treatment involves monitoring the patient in a cool, shady environment and ensuring adequate hydration. […] Prompt recognition and immediate cooling through evaporation or full-body ice-water immersion are crucial. […] Physicians also must monitor electrolyte abnormalities, be alert to signs of renal or hepatic failure, and replace fluids in patients with heatstroke. […] Most experts believe that physicians and public health officials should focus greater attention on prevention.

• #55 Heat Stroke Symptoms, Treatment, Prevention and More – Dr. Axe

  https://draxe.com/health/heat-stroke-symptoms/

  Heat stroke is a medical emergency that occurs when the body can no longer cool itself. […] To ensure that your health is never put in harms way because of hot weather, take preventative measures to keep yourself cool and stay hydrated. […] Heat exhaustion happens when the heat begins to make you feel uncomfortable and ill, leading to symptoms, such as: heavy sweating, weakness, headache, changes in pulse, cold, pale and clammy skin, nausea, vomiting, fainting. If left untreated, heat exhaustion can advance to heat stroke. […] Studies show that when cooling is quickly initiated, and both the body temperature and brain function return to normal within an hour of symptom onset, most patients recover fully. […] For patients suffering from heat stroke, cold water immersion is one of the most common ways to cool the patients core temperature quickly.

• #56 Heat Stroke Symptoms, Treatment, Prevention and More – Dr. Axe

  https://draxe.com/health/heat-stroke-symptoms/

  The patient also may be given intravenous (IV) hydration and be transported to a hospital if hes not already at one. […] To prevent heat stroke, take the following precautions when exposed to hot temperatures: Drink Plenty of Water. […] If youre taking any of these kinds of medications, talk to your doctor about your increased risk of heat stroke. […] When someone suffers from heat stroke, her body temperature most be reduced immediately, and she must be hydrated intravenously until her fluid levels return to normal.

• #57 Heat-related health problems | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/healthyliving/heat-stress-and-heat-related-illness

  Heat can cause serious and potentially fatal health problems such as heat exhaustion and heatstroke, trigger sudden events like heart attack or stroke, or worsen existing medical conditions like kidney or lung disease. […] First aid for heat exhaustion includes: Seek immediate medical assistance by calling Nurse-on-Call on 1300 60 60 24 for 24-hour health advice, transporting the person to a doctor or emergency department, or contacting the Victorian Virtual Emergency Department for non-life-threatening emergencies. […] Heatstroke is a medical emergency and requires urgent attention: Call Triple Zero (000) immediately for an ambulance. […] First aid for dehydration due to heat includes: Move to a cool area and rest. Drink plenty of fluids. Remove unnecessary clothing. Cool down by wetting the skin with cool water. See a doctor if there is no improvement or you are concerned. […] Heat exhaustion is a serious condition that can progress to heatstroke. […] Heatstroke can occur when the core body temperature rises above 40 C and blood flow to internal organs is restricted. Many organs in the body suffer damage and the body temperature must be reduced quickly.

• #58 Heat stroke in adults – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/3000174

  Heat stroke is a medical emergency. Clinical features include a core body temperature 40C and central nervous system dysfunction (e.g., altered level of consciousness ranging from confusion to coma [encephalopathy], seizures) in the context of passive exposure to severe environmental heat (classic heat stroke) or strenuous exercise (exertional heat stroke). […] Start rapid active cooling immediately, based on clinical suspicion regardless of degree of hyperthermia and measuring technique. Aim to achieve a target temperature of no less than 39C. Stop cooling once this temperature is reached. […] Cold or ice water immersion is the preferred method for patients with exertional heat stroke. Use wetting and fanning the skin in patients with classic heat stroke and consider wetted ice packs or chemical cold packs as adjunctive cooling.

• #59 Heat stroke – Wikipedia

  https://en.wikipedia.org/wiki/Heat_stroke

  Treatment is by rapid physical cooling of the body and supportive care. Recommended methods include spraying the person with water and using a fan, putting the person in ice water, or giving cold intravenous fluids. Adding ice packs around a person is beneficial but does not by itself achieve the fastest possible cooling. […] Treatment of heat stroke involves rapid mechanical cooling along with standard resuscitation measures. The body temperature must be lowered quickly via conduction, convection, or evaporation. During cooling, the body temperature should be lowered to less than 39 degrees Celsius, ideally less than 38-38.5 degrees Celsius. […] In hospital mechanical cooling methods include ice water immersion, infusion of cold intravenous fluids, placing ice packs or wet gauze around the person, and fanning. Aggressive ice-water immersion remains the gold standard for exertional heat stroke and may also be used for classic heat stroke. This method may require the effort of several people and the person should be monitored carefully during the treatment process. Immersion should be avoided for an unconscious person but, if there is no alternative, it can be applied with the person’s head above water. A rapid and effective cooling usually reverses concomitant organ dysfunction.

• #60 Heat stroke – Wikipedia

  https://en.wikipedia.org/wiki/Heat_stroke

  Dantrolene, a muscle relaxant used to treat other forms of hyperthermia, is not an effective treatment for heat stroke. Antipyretics such as aspirin and acetaminophen are also not recommended as a means to lower body temperature in the treatment of heat stroke and their use may lead to worsening liver damage. […] The person’s condition should be reassessed and stabilized by trained medical personnel. And the person’s heart rate and breathing should be monitored. IV fluid resuscitation is usually needed for circulatory failure and organ dysfunction and is also indicated if rhabdomyolysis is present. In severe cases hemodialysis and ventilator support may be needed.

• #61 Expert consensus on standardized diagnosis and treatment for heat stroke | Military Medical Research | Full Text

  https://mmrjournal.biomedcentral.com/articles/10.1186/s40779-015-0056-z

  Heat stroke is a life-threatening disease characterized clinically by central nervous system dysfunction and severe hyperthermia (core temperature rises to higher than 40 C). Rapid cooling to reduce core temperature as quickly as possible is the primary and most effective treatment, as it has been shown that the major determinant of outcome in heatstroke is the degree and duration of hyperthermia. If suppression of body temperature is delayed, the fatality rate will be elevated. […] Heat exhaustion refers to a group of clinical syndromes that are characterized by hypovolemia after heat stress. […] Clinical manifestations include sweating, fatigue, weakness, vertigo, headache, poor judgment, nausea, and vomiting. […] Heat exhaustion can progress to heat stroke if not diagnosed and treated in a timely manner; therefore, heat exhaustion patients should immediately be sent to the hospital for treatment.

• #62 Expert consensus on standardized diagnosis and treatment for heat stroke | Military Medical Research | Full Text

  https://mmrjournal.biomedcentral.com/articles/10.1186/s40779-015-0056-z

  Treatment Principle: Rapid cooling and intravenous infusion are required when there is a severe reduction in blood volume or an electrolyte imbalance. […] If the blood pressure fluctuates with body position, then the patient should continue to be replenished with saline until hemodynamics are stabilized. […] Early effective treatment is the key to determining the prognosis. The crucial points in effective treatment are rapid lowering of the core temperature, blood purification, and DIC prevention. […] Specific treatment measures are nine early and one ban, that is, early cooling, early expansion, early blood purification, early sedation, early intubation, early correction of coagulation dysfunction, early resistance to infection, early enteral nutrition, early immunoregulation, and a ban on surgical operations during the period of coagulation dysfunction.

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